Provider Demographics
NPI:1255389938
Name:NIPPER, NEIL BAKER (MD)
Entity type:Individual
Prefix:DR
First Name:NEIL
Middle Name:BAKER
Last Name:NIPPER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:350 JACKSON CIRCLE
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:FL
Mailing Address - Zip Code:32580-1638
Mailing Address - Country:US
Mailing Address - Phone:850-543-0642
Mailing Address - Fax:
Practice Address - Street 1:350 JACKSON CIRCLE
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:FL
Practice Address - Zip Code:32580
Practice Address - Country:US
Practice Address - Phone:850-883-8288
Practice Address - Fax:850-883-8192
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS31138207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine